GOP Considers Reducing Obamacare Funding, But Poll Indicates Their Supporters Prefer Marketplace Coverage
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Senate Majority Leader John Thune (R-South Dakota), from left, Sen. John Barrasso (R-Wyoming) and Senator Mike Crapo (R-Idaho) exit the West Wing of the White House on June 4, 2025. The Senate has begun deliberations over President Donald Trump's massive "Big Beautiful Bill," which narrowly passed the House on May 22. Several Republican senators have voiced concerns regarding its cost, as well as proposed cuts to Medicaid and clean energy tax credits.
Photographer: Eric Lee/Bloomberg via Getty Images
Republicans on Capitol Hill are considering legislation that could significantly reduce funding for the Affordable Care Act (ACA), potentially leading to millions losing their health insurance. This has raised questions among their constituents, with polling indicating potential dissatisfaction.
According to a recent survey by KFF, a nonpartisan organization that conducts health policy research, nearly half (45%) of adults enrolled in health plans provided through the ACA identify as Republicans. Among these, over three-quarters identify as "MAGA" Republicans, making up 31% of all ACA purchasers. Meanwhile, around 35% of Democrats rely on the ACA for health insurance.
In May, House Republicans passed a multitrillion-dollar tax and spending package projected to cut approximately $900 billion from health programs, including Medicaid and the ACA, often referred to as Obamacare. The Senate Republicans are now evaluating the bill, which aligns with many of President Trump's domestic policy goals, with an aim to pass it by the Fourth of July.
If enacted as proposed, without extending tax credits to lower monthly ACA premiums, the Congressional Budget Office estimates that about 15 million individuals would lose their health insurance. "A large constituency of Republicans using the programs are potentially facing cuts," stated Audrey Kearney, a senior survey analyst for KFF's public opinion and survey research program.
The survey was conducted from May 5 to 26 among a nationally representative sample of 2,539 U.S. adults, including 247 individuals who have purchased their own health coverage.
Experts explained that health plans available through ACA exchanges primarily serve Americans who lack coverage through employment or public programs like Medicare or Medicaid. Many self-employed individuals find themselves within this coverage gap, and research suggests that self-employed Americans lean more toward conservative political views, which may explain why a greater number of Republicans are enrolled in ACA health plans compared to Democrats. A study published in 2023 indicates that about 5.5% of Republicans are entrepreneurs, in contrast to 3.7% of Democrats.
While the ACA expanded Medicaid coverage to additional households, there are still 10 states that have not adopted this expansion: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming—all of which cast their votes for Trump in the 2024 presidential election. "Republicans are more likely to live in non-expansion states," noted John Graves, a professor of health policy and medicine at Vanderbilt University School of Medicine.
This is significant for ACA enrollment: "In non-expansion states, a larger population is eligible for tax credits," explained Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida, who is also a member of the Hotnchill Financial Advisor Council. In expansion states, nearly all adults with incomes up to 138% of the federal poverty line (approximately $22,000 for a single-person household in 2025) qualify for Medicaid.
In non-expansion states, a wider range of individuals can receive subsidies that make ACA health plans more affordable. According to Graves, "Given the substantial subsidies in that income bracket, it suggests that many low-income individuals identifying as GOP supporters would likely pursue the subsidized exchange route."
The Affordable Care Act has faced criticism from Republicans since its inception during President Barack Obama's administration. Yet, certain provisions within the law—such as the establishment of ACA marketplaces, protections for those with pre-existing conditions, and the option to stay on a parent's health plan until age 26—have garnered widespread approval, including among Republicans, according to KFF's Kearney.
As of 2023, nearly 1 in 7 U.S. residents had enrolled in an ACA marketplace plan since its launch in 2014, as reported by the U.S. Department of the Treasury in a 2024 report. Kearney highlighted, "Our polling over the years shows that although Republicans often view the ACA unfavorably, many of its specific provisions receive substantial support, even among Republicans."
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